*Purpose: Kidney transplantation is the standard treatment for patients with ESRD. Very limited advancement has been made in its surgical aspects. Minimal invasive approach for living donors has become the standard of practice but for transplantation the open approach has largely remained unchanged. Robotic-assisted kidney transplantation (RAKT) is the relatively new surgical technique and remains in infancy. Very few transplant centers across the world are currently performing kidney transplants using this approach. Most centers are performing RAKT with hand assistance. We are reporting our initial experience with robotic (non-hand assisted) technique.

*Methods: We retrospectively analyzed all the RAKT performed from June 2018 to January 2019. Demographic information of the donors, recipients, and technical aspects of the surgery, relevant operative details, post-operative course and complications were recorded and analyzed.

*Results: We performed a total of 11 non-hand assisted RAKT with median age of 34 (24-59 years). Demographic profile and operative details are described in table 1. All kidneys were implanted on the right side and seven of them were retroperitonealized. One patient required conversion to open because of bleeding from renal vein during attempted retroperitonealization and second was converted because of visually pale looking kidney (on conversion kidney was well perfused). None of our patients had delayed graft function or any surgical site infection. Most common postoperative complication was hypertension. None of the patients had Clavien Dindo-3 or higher complications.

*Conclusions: Our early results suggest that non hand assisted RAKT is a technically feasible procedure and appears to be a safe surgical alternative to the standard open approach with excellent outcomes.

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